Marijuana (Weed) Withdrawal

What is marijuana withdrawal?

Marijuana (weed) withdrawal is the collection of mental, emotional and physical symptoms you may feel if you stop using marijuana after regular use. The DSM-5 calls this cannabis withdrawal syndrome.

When you use marijuana products, your body and brain become used to THC (tetrahydrocannabinol). This is the major psychoactive component of marijuana that has addiction potential. When you cut back on or quit using THC-containing products, the lack of THC in your body can cause uncomfortable symptoms, like irritability and insomnia.

Marijuana withdrawal doesn’t cause any life-threatening symptoms. But it’s one of the signs of cannabis (marijuana) use disorder, which can significantly impair your life. It’s important to seek medical help if you have cannabis use disorder or any type of substance use disorder.

How common are marijuana withdrawals?

In an analysis of studies of more than 23,000 people, researchers found that 47% of people who used marijuana regularly experienced withdrawal symptoms.

Research also shows that the levels of THC in marijuana have been increasing over the past couple of decades. This may make marijuana withdrawal increasingly common.

What are the symptoms of marijuana withdrawal?

The most common marijuana withdrawal symptoms include:

• Anger, irritability and aggression.
• Nervousness and anxiety.
• Restlessness.
• Decreased appetite, which may lead to weight loss.
• Depressed mood.
• Insomnia.
• Disturbing dreams and nightmares.

Less common physical symptoms include:

• Headaches.
• Nausea and vomiting.
• Excessive sweating.
• Abdominal pain.
• Shakiness (tremors).

These symptoms aren’t life-threatening, but they can be very uncomfortable.

Symptoms of marijuana withdrawal usually begin within the first 24 to 48 hours of stopping or significantly reducing marijuana use after heavy, long-term use. The severity of the symptoms typically peaks by day three.

How long does marijuana withdrawal last?

How long cannabis withdrawal lasts and the severity of it is associated with the amount of marijuana (THC) you consumed before stopping. Both the length and severity can vary considerably.

Symptoms can last for up to two weeks. But certain symptoms can last up to three weeks or more in people who’d used marijuana very often.

What causes marijuana withdrawal?

Scientists are currently studying all the mechanisms that go into marijuana withdrawal. So far, they know that it’s based on complex interactions involving:

• THC-induced neurobiological changes.
• Genetic and epigenetic factors.
• Environmental factors.
• Having mental health conditions or other substance use disorders.
• Personality traits.
• Your stress response.

In general, withdrawal happens when your brain and body become used to having a substance in your system. In the case of marijuana withdrawal, it’s THC.

When you regularly use marijuana (THC), your body may build tolerance and dependence. Tolerance means that it takes larger doses of THC to experience its effects. Dependence happens when your body requires THC to avoid withdrawal symptoms.

If you suddenly stop or significantly decrease your intake of marijuana, it throws your body and brain off balance, and you may develop symptoms of withdrawal.

Risk factors for marijuana withdrawal

Not everyone who uses marijuana experiences withdrawal when they stop using it. In addition, the severity of withdrawal symptoms can vary widely from person to person.

Studies show that marijuana withdrawal is more likely to affect people who:

• Use marijuana daily.
• Use more potent marijuana (higher levels of THC) or engage in “dabbing.” This form of marijuana use involves a concentrated form of THC, with levels as high as 80%.
• Use both marijuana and tobacco.
• Have other substance use disorders.

People who have the following mental health conditions are more likely to experience severe withdrawal symptoms than those without these conditions:

• Mood disorders.
• Anxiety disorders.
• Personality disorders.
• Post-traumatic stress disorder (PTSD).

How is marijuana withdrawal diagnosed?

There’s no specific test that can detect marijuana withdrawal. Instead, healthcare providers diagnose it if you have three or more withdrawal symptoms within one week of decreased marijuana use.

In some cases, your provider may order other tests (like blood tests) to make sure your symptoms aren’t due to another condition.

What is the treatment for marijuana withdrawal?

Marijuana withdrawal alone rarely requires medical care. But you may benefit from or need detoxification in a hospital or facility if you:

• Have one or more mental health conditions.
• Have a physical health condition that withdrawal symptoms may worsen.
• Have severe cannabis (marijuana) use disorder.
• Use or misuse multiple substances, including opioids, alcohol and benzodiazepines, in addition to marijuana. Withdrawal from these substances can be dangerous and potentially fatal.

Currently, the U.S. Food and Drug Administration (FDA) hasn’t approved any medications for marijuana withdrawal, specifically. But researchers are actively studying medications for medically assisted withdrawal (MAW) of marijuana.

Treating and preventing marijuana relapse and cannabis use disorder

Withdrawal symptoms can increase your risk of marijuana use relapse (using marijuana again). And withdrawal is a significant sign of cannabis (marijuana) use disorder (CUD). Because of this, it’s important to seek professional help to prevent relapse and prevent or treat CUD.

Psychotherapy (talk therapy) can help treat CUD and any other co-occurring mental health conditions. Therapy also teaches healthy coping mechanisms. Some examples of effective therapies include:

• Cognitive behavioral therapy (CBT): CBT is a structured, goal-oriented type of psychotherapy. During CBT, a mental health professional helps you closely examine your emotions and thoughts. You can unlearn negative thoughts and behaviors through CBT and learn to adopt healthier habits and ways of thinking.
• Dialectical behavior therapy (DBT): DBT is especially effective for people who have difficulty managing and regulating their emotions. DBT has proven to be effective in treating and managing many mental health conditions, including CUD.
• Contingency management (CM): CM encourages healthy behaviors by offering rewards for desired behaviors. Usually, the treatment provides an item of monetary value to people with CUD to incentivize them not to use cannabis. For example, you earn a chance to get a gift card or prize with a negative drug test result.

Participating in self-help programs, like Marijuana Anonymous, can also play a significant role in CUD treatment.

Can I prevent marijuana withdrawal?

The only surefire way to prevent marijuana withdrawal is to avoid using it. If you do use marijuana, there’s no guaranteed way to prevent withdrawal. You should be cautious about:

• How often you use marijuana.
• The level of THC (potency) in the product.
• How you use it (like smoking, eating or dabbing).
• The signs of cannabis use disorder.

If you’re concerned about developing CUD, talk to your healthcare provider sooner rather than later.

When should I see my healthcare provider about marijuana withdrawal?

While marijuana withdrawal symptoms can be unpleasant, the symptoms themselves typically don’t require medical care. If your symptoms are severe or you have a co-existing mental health condition, see your healthcare provider.

If you experience marijuana withdrawal, you may have cannabis use disorder. CUD can significantly impair your life and become more severe. It’s essential to seek professional help if you have CUD.